Nurse‐initiated analgesia pathway for paediatric patients in the emergency department: A clinical intervention trial

Abstract

The NIAP significantly reduced time to analgesia. It was associated with high levels of parental satisfaction.

Variables associated with administration of analgesia, nurse-initiated analgesia and early analgesia in the emergency department

“…Although the extent and degree of this problem has recently been challenged,2 it is likely that considerable scope remains for improvement in ED pain management practice. Initiatives to improve pain management have included staff training,3 mandatory recording of pain scores,4 nurse-initiated analgesia (NIA, prescribed and administered by a nurse),5 time-to-analgesia performance indicators6 and the provision of ‘adequate analgesia’ as measured by changes in the pain score 7 8. The overall aim of these initiatives is to provide early, safe and effective analgesia to those with valid indications.…”

“…These expectations informed the development of NIA programmes which provide an opportunity for treatment at triage or shortly after admission to an ED cubicle. In some UK, USA, Irish and Australasian EDs, nursing staff are credentialled to administer oral and parenteral analgesia, including opioids, for a wide range of presenting complaints and without a prescription from an ED doctor 5. It has been reported that NIA promotes more timely analgesia administration,12 increases pain management satisfaction13 and affects the patients' perceptions of the quality of their pain management 14…”

Assessment of orofacial pain management in a pediatric emergency department and at home after discharge

“…The latter would make optimal pain management conditional to early treatment. 21,22 The following may be considered limitations of this study: first, data were partially collected from medical records and reports, so certain aspects may not have been adequately reflected. However, it was necessary to collect data this way because health care staff seeing patients had to be blinded to the study so as to avoid any interference with their routine clinical practice.…”

Evaluación del manejo del dolor de la patología facial y oral en un Servicio de Urgencias Pediátrico y tras el alta domiciliaria

“…Posibles actuaciones para llevar a cabo podrían ser la obligatoriedad de rellenar un campo de evaluación del dolor en el triaje y en el informe médico, y la administración de analgésicos lo más precoz posible, incluso en el triaje. Esto último condicionaría 21,22 el mejor control del dolor debido al tratamiento precoz de este.…”